Canterbury Language Training

Registration Form

Course
Start date (dd/mm/yyyy)
End date (dd/mm/yyyy)
Course One-to-One Training hours per week.
2-week Micro-Group Training
1-week Micro-Group Training
1-week Combination Training
2-week Combination Training
3-week Combination Training
The Director will advise you about the structuring of Combination Training

Optional Services
Evening Social Programme
Lunches
Family Accommodation
Hotel Accommodation
Please state below any personal preferences to help us organise your host family or hotel
Smoking
Other (e.g. diet, allergies, pets)
Arrival Transfer
Departure Transfer
Specify locations, if known
London Airports
Ashford International

Your personal details
Family Name
First Name
Nationality
Date of Birth (dd/mm/yyyy):
Home Address
Work Telephone
Home Telephone
Mobile Telephone
Email Address
When and where did you last study English?

Company details
Company Name
Company Address
HR/Training Manager
Company Telephone
Company Fax
Company Email Address

Additional Information
How did you hear of CLT?
Agents Name (if applicable)
Method of Payment Bank Draft
Bank Transfer
VISA card
Mastercard/Eurocard
American Express

Background

Please complete this section carefully. The information provided will help us plan your course.
What is the nature of your company´s business?
What is your position/profession in your company?
What is your main function?
Please estimate your level of English
Speaking
Understanding
Reading
Writing
Please tell us what you think are your main strengths and weaknesses in English
Why do you need English?
What do you want to be able to do after your training?
Is there anything else you would like us to consider when planning your training?
A copy of this form will be sent to your email address, if you supplied one. We recommend that you print or save this form for your own records before submitting it, using the Print or Save function of your browser.